Nhra Heads Of Agreement
On 29 May, the Council of Australian Governments (COAG) approved several amendments to the National Health Reform Agreement (NHRA), which will come into force on 1 July 2020. Compliance with NHRA conditions is critical for public health facilities seeking access to Medicare discounts for private health services at those facilities. The amendments include strengthening the monitoring and notification of rights to private services in public hospitals. In February 2018, COAG drew up an agreement on new public hospital funding schemes for the period 2020/21-2024/25. As part of these agreements, coAG has negotiated a new addition to the NHRA that will come into effect on 1 July 2020 (new addendum). An external review of the new addendum will be completed by December 2023. Bilateral Agreement on Commonwealth Minimum Funding of Public Hospital Services From 1 July 2020, Annex J – Addendum to the National Health System Reform Agreement: Revised Public Funding of Hospitals and Health System Reform Schemes will enter into force. [PDF 2.71 MB | DOCX 182KB] 3. Provision of data to private health insurers and certification documentation Finally, the external review, to be completed by December 2023, will include a review „of the emergence of unintended consequences such as cost transfers, perverse incentives or other inefficiencies affecting patient outcomes, and the ability of the parties to adopt innovative models as a result of financial and other agreements; and „included in the new addition. If you have any questions about the new addendum or would like to discuss the impact on your organization, please contact one of our specialist lawyers. It is important that the changes are beneficial to public health, since the new addition: the new addition also provides that as of July 1, 2020, the administrator should identify cases that should not have qualified for the payment of a Medicare, PBS or private health insurance payment, and refer them to the appropriate Commonwealth official to support compliance activities through mechanisms outside of the new addition. The commercial rules relating to the comparison of data are defined by the administrator in consultation with the parties. The Commonwealth is committed to consulting states on any changes to these rules affecting the practices of public hospitals.
It is recognised that changes to data provision requirements should prevent excessive additional administrative burdens on public hospitals. According to the rules, private insurers cannot ask public hospitals for certification documents beyond those prescribed by the National Private Patient Hospital Hospital, nor delay or refuse payment of fees for legitimate hospital care. In the event of insufficient or erroneous information, insurers should first cooperate with the public hospital in order to obtain more information. A consolidated version of the National Health Reform Agreement [PDF 1.35MB | DOCX 195KB] Two new clauses have been added to Annex G (Commercial Rules). They require that additional written documents or oral material on the choice to be treated privately do so: the new addition requires that „authorized persons have the choice to receive public hospital services free of charge as public patients“ and are no longer linked to the types of services „that have been provided currently or historically by hospitals.“ It is likely that this amendment will allay previous concerns about the nature of the services provided, given the historical provision of services in hospitals. . . .